Preventing Dehydration in Older Adults
What is dehydration?
Dehydration is a lack of fluid in the body. It often is caused by poor fluid intake or by losing too many fluids through normal body processes. Fluid is critical to most body functions. It is important for carrying oxygen and energy to the body, as well as carrying away waste products.
With adequate fluid intake, the body has the right amount of fluids and electrolytes for proper functioning. When a person is dehydrated, the body becomes starved for oxygen and other nutrients, and the body cannot remove waste products. Lack of fluid sometimes is dangerous and even fatal. The human body cannot store fluid, so it must replace it every day.
Is dehydration more common in older adults?
Yes. Studies show that one in three older adults may not get enough fluid. Older adults tend to become dehydrated for several different reasons. As a rule, older adults have less body water than younger adults—50% of their weight is water vs 60% for younger adults. Also, their kidneys may function less efficiently. Older adults have a decreased thirst sensation, so they may not recognize that they are thirsty.
In addition, with aging come changes in physical condition, such as the ability to walk, reach for a nearby glass, or feed oneself, making access to fluids perhaps more difficult. A decline in cognitive skills (confusion, poor memory, etc) also can cause a decrease in fluid intake.
What other things affect hydration status?
Dehydration can result because of the environment. For example, in a humid environment we perspire more, resulting in fluid loss. Sometimes medications, especially diuretics, can result in fluid loss. Laxatives also can cause extra fluid loss. Patients with a fever also need more fluids.
What are the signs and symptoms of dehydration?
Dehydration is identified many different ways. Weight loss, increased heart rate, low blood pressure, decreased skin turgor, dry mouth and tongue, decreased urination, constipation or fecal impaction, nausea, anorexia, sunken eyeballs, and decreased functional ability are all symptoms of dehydration. In some cases, problems such as weakness, trembling, lethargy, or confusion can result from dehydration.
How much fluid does a person need every day?
Contrary to popular opinion, everyone does not need eight 8-ounce (oz) glasses of water each day. Fluid needs are based on a person’s body size and medical history. A registered dietitian can help you figure out how much fluid is needed. Milk, juice, coffee, tea, and water all count as sources of fluids. In general, unless you are drinking very large volumes of liquids, it is better to drink too much than too little.
Is there fluid in foods?
Yes. Individuals who eat well can get the equivalent of two to three 8-oz glasses of water from the fluids found in the foods they eat. Fruits and vegetables have high water content, as do soups, gelatin, and pudding. Dry foods, such as snack foods, cookies, and cheeses, have low water content. If a person is not eating well, they may need additional fluids to make up for the fluids lost in the foods they are not consuming.
How can you prevent dehydration in an older adult?
You can prevent dehydration in older adults many different ways. Consider these suggestions:
· Provide favorite fluids during and between meals
· Serve cold beverages cold and hot beverages hot
· Encourage fluid intake at meals and snacks
· Keep fluids nearby and offer them frequently, if assistance is needed
· Remind older adults to drink
· Watch for signs and symptoms of dehydration
· Watch for a poor intake of food or fluid
· Provide liquids with medicines
References and recommended readings
Chernoff R (ed). Carbohydrate, fat, and fluid requirements in older adults. In: Geriatric Nutrition. 3rd ed. Sudberry, MD: Jones and Bartlett Publishers; 2006.
Kobriger AM. Hydration: Maintenance, Dehydration, Laboratory Values, Clinical Alterations. Chilton, WI: Kobriger Presents, Inc; 2005.
Mentes J. Oral hydration in older adults: greater awareness is needed in preventing, recognizing, and treating dehydration. Am J Nurs. 2006;106:40-49.
US Dept Agriculture, Center for Nutrition Policy and Promotion. More than one in three older adults may not drink enough water. Nutrition Insights [serial online]. September 2002;27:1-2. Available at: http://www.cnpp.usda.gov/Publications/NutritionInsights/Insight27.pdf. Accessed April 20, 2011.
Review Date 4/11
G-1569